Räihä Juulia, Helanterä Ilkka, Ekstrand Agneta, Nordin Arno, Sallinen Ville, Lempinen Marko
Department of Transplantation and Liver Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Ann Transplant. 2019 Jul 19;24:426-431. doi: 10.12659/AOT.916649.
BACKGROUND Pretransplant dialysis modality may affect outcome after simultaneous pancreas-kidney transplantation (SPKT), and it has been suspected that peritoneal dialysis (PD) is associated with more postoperative complications compared to hemodialysis (HD). The aim of this study was to evaluate whether pretransplant dialysis modality affects the risk for postoperative complications in SPKT recipients. MATERIAL AND METHODS This was a retrospective longitudinal cohort study of all patients undergoing SPKT from 2010 to 2017, during which 99 simultaneous pancreas-kidney transplantations were performed. Three pre-emptive transplantations were excluded. Patient groups receiving PD (n=59) or HD (n=37) were similar regarding baseline characteristics. All complications occurring during the first 3 months after transplantation, as well as patient and graft survival, were analyzed. RESULTS There were no significant differences in postoperative complications between groups, with similar rates of intra-abdominal infections (8% in HD vs. 10% in PD), pancreatitis (16% in HD vs. 17% in PD), gastrointestinal bleedings (22% in HD vs. 10% in PD), and relaparotomies (27% in HD vs. 24% in PD). None of the patients had venous graft thrombosis. Past peritonitis was not associated with increased risk for postoperative complications in PD patients. Patient and graft survival were similar between PD and HD groups. CONCLUSIONS Peritoneal dialysis is not a risk factor for postoperative complications after SPKT.
移植前透析方式可能会影响胰肾联合移植（SPKT）后的结局，并且有人怀疑与血液透析（HD）相比，腹膜透析（PD）与更多的术后并发症相关。本研究的目的是评估移植前透析方式是否会影响SPKT受者术后并发症的风险。
这是一项对2010年至2017年期间所有接受SPKT的患者进行的回顾性纵向队列研究，在此期间共进行了99例胰肾联合移植。排除3例抢先移植。接受PD（n = 59）或HD（n = 37）的患者组在基线特征方面相似。分析了移植后前3个月内发生的所有并发症以及患者和移植物的存活率。
两组术后并发症无显著差异，腹腔内感染发生率相似（HD组为8%，PD组为10%），胰腺炎发生率相似（HD组为16%，PD组为17%），胃肠道出血发生率相似（HD组为22%，PD组为10%），再次剖腹手术发生率相似（HD组为27%，PD组为24%）。所有患者均未发生静脉移植物血栓形成。既往腹膜炎与PD患者术后并发症风险增加无关。PD组和HD组的患者及移植物存活率相似。
腹膜透析不是SPKT术后并发症的危险因素。
